Nicholas J Melville, LLPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6451019552 Issued in MI

Practice address

1360 Baldwin St
Jenison, MI 49428-8937

Phone

(616) 202-1910

NPI assigned

Jul 30, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2007

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Great Lakes Wellness Counseling LLC

  • Professional Counselor
  • Grandville, MI
  • NPI 1437651916
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1154094605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6568 W MILL RUN SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493167861",
            "telephone_number": "616-633-0269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 BALDWIN ST",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494288937",
            "telephone_number": "616-202-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELVILLE",
        "first_name": "NICHOLAS",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LLPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-30",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6451019552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medexpress Urgent Care, PC - Michigan
• Matthew Wesley Medley, DO
• Barbara Meeuwsen
• Meijer Inc
• Emily Meindertsma, PT, DPT
• Ashley Mervenne, BT
• Katherine Mesko, OTRL
• Jayme Meyer, RN
• Trisha Lynn Meyers
• Angela Michienzi, RPH

• Professional Counselor in Jenison, MI
• Providers in Jenison, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.